Health Information Technology

At its core, health IT focuses on the management of patient care and access to patient data through the secure sharing of health information. “We’re making these changes in how we work and implementing technology so that clinicians, doctors and nurses can face patients more and work with systems less,” asserts Dr. Steven Davidson, Chief Medical Informatics Officer.

Watch Walter Fahey, CIO, Discuss Some of the
Latest IT Innovations at Maimonides

Physicians that adopt health IT will not only spend less time with computer systems, but they will also reduce the tedious steps required to schedule a follow-up appointment, get a consultation, prescribe medicine and access lab results, as well as many other administrative tasks.

Meaningful Use and EHRs

The Centers for Medicaid and Medicare Services (CMS) promises that eligible physicians can receive incentive payments. By 2015, if physicians choose not to adopt EHRs, they will be penalized with a 1% reduction of their reimbursements. This penalty will move to a 3% reduction over the next three years.

In order for physicians to receive CMS stimulus money, ARRA requires clinicians to show "Meaningful Use" of their EHR. Meaningful Use requirements are put in place to ensure that providers are using EHR technology in ways that can be quantitatively and qualitatively measured.

Meaningful Use Requirements

Over the next five years, Meaningful Use requirements will roll out in three stages:

Stage 1 (2011 and 2012): Sets the standard for electronic capture of patient data and the sharing of this information.

Stage 2 (expected in 2013) and Stage 3 (expected in 2015): Providers will continue to expand on this baseline, using the data collected in previous stages to analyze trends, develop treatment plans, and create better ways of improving care and sharing data.

One of the first capabilities of EHRs that Maimonides implemented is Computerized Provider Order Entry (CPOE). Maimonides had full CPOE for all inpatients by the end of 1996, and by 2002 it was fully implemented for Emergency Medicine. This system is valuable to healthcare providers because CPOE offers clinical decision support, which helps the prescriber understand the unintended consequences of his or her order. “To a degree it’s been a tool that has appropriately helped us reduce patient length of stay,” states Dr. Davidson.

For example, if a patient takes an aggressive long-term medication for a chronic condition, it may be necessary for physicians to routinely check the function of certain vital organs. Through a notification system CPOE reminds physicians to follow-up with their patients. CPOE helps with ePrescribing as well. A physician’s first impulse for an antibiotic prescription may conflict with a current drug taken by his or her patient – or the dosage may need to be adjusted because this patient is a smoker. CPOE will notify the physician of these changes. “That being said, CPOE does not lead to cookbook medicine,” asserts Dr. Davidson. “It’s not that a doctor can’t remember these things, but clinical decision support can offer choices and opportunities to move the patient along the process of care.”

Connecting For Care Maimonides EHR Subsidy Program

“Maimonides has committed to fund 85% of a private practice physician’s purchase of an integrated Allscripts Enterprise EHR and practice management system, which is the maximum subsidy permitted under federal regulations,” asserts Peterson. In addition, Maimonides will fund 85% of the first year of the ongoing service costs related to software hosting and maintenance. The software and services in the Maimonides program for private practices includes:

Reference labs and radiology imaging for electronic orders and results

Brooklyn Health Information Exchange (BHIX)

New York Citywide Immunization Registry (CIR)

All implementation services, including on-site training and go-live support

With this subsidy program, Maimonides has committed to support 25 physicians in 2011 and an additional 25 in 2012. The primary focus of this program will be on physicians who practice general internal medicine and pediatrics. Certain clinicians who have medical and surgical sub-specialties may also be eligible, if they serve as a primary care provider for more than 50% of their patients and are critical to the care of populations on which Maimonides’ HEAL grants focus (patients who are frail and elderly, HIV+, or have metabolic disorders frequently associated with severe mental illness).

BHIX: Brooklyn Health Information Exchange

Maimonides offers to enroll all patients in BHIX, a non-profit organization that connects healthcare providers throughout Brooklyn. In this program patients give medial providers the permission to access and share their health information. This exchange of information results in improved quality, efficiency and safety of treatment for the patient across multiple care settings.

Maimonides is investing in the build-out of the BHIX provider portal and messaging system. This program allows e-Referrals across EHR applications and alerts participating physicians to critical events such as admissions or discharges from Maimonides and other BHIX member hospitals.

Telestroke Medicine: Electronic Patient Access to Expert Care

Barriers to quality care, such as location of the hospital, time of patient admission, and availability of an expert physician, become increasingly apparent when dealing with time-sensitive interventions such as a stroke. Fortunately, health IT and the emergence of telestroke medicine have created viable options to quickly and effectively diagnose and treat patients.

“Stroke therapy is highly time-dependent and needs to be delivered rapidly,” explains Dr. Steven Rudolph, Director of the Jaffe Stroke Center at Maimonides. “Even in a city, patients can have limited access to neurological care when physicians are not on the premises at night.”

For more on our telestroke program, watch as Dr. Rudolph explains the development of this technology and the importance we at Maimonides place on this live-saving advancement. To watch this video, click here.